Ebola Q&A: Robyn Klein

The recent Ebola outbreak has been plastered over headlines for weeks. Many people have come up with crazy conspiracy theories surrounding the outbreak and others think it is the impending apocalypse, but most do not know the real facts.

Globe reporter Ellie Tomasson spoke to infectious disease expert and professor at Washington University Robyn Klein regarding Ebola.

Q: How infectious is Ebola?

A: So, it is an infectious disease. It is contagious; however, the only way to get Ebola is to really come in contact with the bodily fluids of someone who has it. Contact means mucous membranes: eye, throat, nose. But the thing about Ebola is that it’s not airborne, so it doesn’t affect the lungs. It’s never been contagious via respiratory route. You can’t get it from sitting next to somebody that doesn’t have symptoms. They would really have to throw up on you. So the people who have gotten Ebola are mostly people who are caring for patients with Ebola and aren’t wearing protective equipment.

Q: What are the extra precautions being taken in hospitals after the outbreak?

A: There is Ebola preparedness that is ongoing in many hospitals. Washington University, Barnes Jewish Hospital as an example. There is an Ebola team: physicians who are being trained to handle any Ebola cases that could possibly present. There is an algorithm or a structure for dealing with a patient who meets criteria for possibly having Ebola. That would of course be anybody who has come in contact with somebody with Ebola or has come from one of the countries in current epidemic and has the appropriate symptomatology that would suggest that is is on the list of possible causes of whatever is making them sick because you have to remember that there are lots of things that can make people have fevers and mialgias, muscle aches, and even vomiting and diarrhea. You sort of think about how likely it is that this is a person who has come in contact with [Ebola] and they’ll be immediately isolated with only certain physicians who have been trained to use the protective equipment. We’ve also now gotten all of that protective equipment and it’s here, so it’s available to use it.

Q: How does the Ebola outbreak compare to other epidemics?

A: There have been much bigger outbreaks of other infectious diseases. HIV is a great example. This is probably similarly contagious in that it has to be [passed] through direct contact with bodily fluids. I think people should think about it that way. It’s hard to get HIV, but that’s a huge epidemic, ongoing, so this kind of pales in comparison to that I think.

Q: Some people are freaking out about Ebola. Is this reaction justified or are people overreacting?

A: So I don’t think this is the Apocalypse. I think that you take all infectious diseases seriously and I think that people should become informed and learn about them. Learn about what the real issues are. And the real issue is not that it’s an impending doom and that everyone here is about to be infecting people. You really can’t get this unless you’re with somebody who’s really symptomatic and the likelihood of a symptomatic person being even admitted onto a plane is very very low, so even imported cases, those few imported cases came from those participating in the care of patients like that physician from the US surely came over during the asymptomatic period because it takes time for the symptoms to develop and the first sign is fever. You’re not really contagious at that point. And then it will take a few days and you’ll start to have a really really high fever before you start developing all of those symptoms. And it’s really unlikely that somebody who’s febrile, looks very sick, is going to be permitted on a plane. People are very vigilant now in the airports and I travel a lot, I can tell you, they’re looking for people with fevers and people who don’t look great especially coming from areas where they might have been exposed to infections like [Ebola]. There are other things also going around. Respiratory illnesses that come from China etc. I think that people are overreacting. I think there’s a lot of crazy panic. I think its its a little bit destructive. I’ve heard of situations where people are being asked to be quarantined and they’re being quarantined, not letting their children into school and I don’t think that that’s appropriate.

Q: What is the mortality rate of Ebola?

A: [The mortality rate] is about 50-70%. For many years this was only occurring in rural villages and in those areas there is very little access to what we would consider modern medical care and so patients couldn’t get all of the supportive care they needed like we could get in and intensive care unit. And certainly if you have access to that and you have access to it early enough, people tend to do better. That doesn’t mean everybody survives, but there are certainly people who will do better.

Q: Is there work being done to find a cure?

A: There are many people who are working on Ebola. In labs all over the world there are people who work on Ebola, that’s the focus of their research. They’re working on novel therapeutics, vaccines, and all of the things that you would imagine you would want to have. These research entities in the US are funded by the NIH. There really hasn’t been a lot of Ebola in the US so the funding level is probably lower for that disease than for other diseases. Science moves slowly, but there have been a couple of new drugs that are investigational for patients, but I think that right now we don’t really have any good treatments.

Q: What specific treatments do you think are being most worked on or will be most effective?

A: So one of the ways the body fights diseases is by making antibodies. Antibodies are usually a pretty good way to fight viral infections. Which is why we have a lot of vaccines for viral infections like the flu. The flu vaccine works really well. It induces an antibody response that neutralizes the virus if you get exposed to it. I believe that there are some labs that are working on antibody based treatments. Making human made antibodies that would be directed at specific proteins made by the virus that cause a lot of the virulence factors. These are the sorts of research endeavours that some labs are working on. The flu is actually, were in the flu season, is much more contagious. Much easier to get. You should remind everybody that they should be getting their flu shots. That’s really important. This is something you can prevent. In the past couple of years we’ve had pretty bad flu seasons in fact kids have been really hit hard. there were some deaths of children. This is a really important and preventable viral infection.

Ebola won’t be running rampant through the streets anytime soon, so instead of concerning about that, try to quash the approaching Flu season. Get your Flu shots and wash your hand because this is much more of a real and present threat than Ebola.